The Covid-19 pandemic brought everything to a stand-still with the entire world’s healthcare resources focused on beating the deadly corona virus. However for these 6 children, waiting was not an option as without a critical liver transplant, survival would be difficult. In the midst of the Covid-19 pandemic and consequent lockdown, the Integrated Liver Care team at Aster RV Hospital went an extra mile to ensure that these 6 children received life-saving liver transplants which have been 100% successful. In Bangalore city very limited organ transplants were conducted due to the pandemic.
Age: 5 years
Diagnosis: Liver failure
Age: 6 years
Age: 7 years
Diagnosis: Acute on chronic Liver failure due to WILSON’s disease
Name: Prerana Pandey
Age: 8 years
Diagnosis: Acute on Chronic Liver Failure (Autoimmune liver disease)
Location: Satna, Madhya Pradesh
All six children were between the ages of 3-10 years and were suffering from end-stage liver disease. In addition to the ILC team’s support, guidance and assurance, hospital subsidy towards the transplant, corporate social responsibility funding from industry and crowd funding came as rays of hope for the families of all six children during the pandemic as they were all unaffordable. CSR to a tune of 20 lakhs, hospital subsidy to a total of 25 lakhs and a cumulative amount of 75 Lakhs was raised through crowdfunding efforts to help support these 6 families. Dr. Rajiv Lochan, Lead Consultant – HPB and Transplant Surgeon, Aster RV Hospital said that, “We call this model our Affordable Liver Transplant programme.”
“Limited scope of travel, unavailability of deceased donor organ donations since the start of the pandemic and logistical challenges with respect to the arrangement of funds were some of the factors which made it difficult for patients to undergo critical organ transplantation surgeries. For patients afflicted with liver disease or acute liver issues, delaying a transplant can have a direct impact on their life expectancy and is very risky. However we had to balance the risk of the COVID -19 infection with the benefit of the treatment and this involved complex logistics which the team was able to organize,” notes Dr. Rajiv Lochan.
Organ donation and transplantation witnessed a significant drop since the start of the pandemic as all the hospital ICUs were fully occupied and there were regulatory changes which affected organ donation too. Unlike kidney-related complications where people have the option of depending on a dialysis machine, for organ transplants of the liver, heart or lungs, many patients do not have the option of waiting. During these difficult times, the onus is on the healthcare providers to accommodate as many critical patients as possible, while maintaining all Covid-19 protocols and also ensuring that other standard operating processes of the organ transplantation process are being strictly adhered to.
“The option of living donor transplants helped us to perform these emergency surgeries for the little ones. Our Affordable Liver Transplant model is an innovative means of ensuring that life-saving transplants are made affordable for all. It is an absolute joy to see them recover well and get back on their feet. The children and their donors and families are the heroes of the pandemic and show us that the human spirit can overcome the most difficult of trials and tribulations,” said Dr. Rajiv Lochan, Lead Consultant – HPB and Transplant Surgeon, Aster RV Hospital
“We were scared when we got to know about our daughter’s condition and we wanted to do the transplant for her as soon as possible. I was an eligible donor and we were prepared for the surgery. Then the pandemic hit and we did not know what to do. The doctors at Aster RV were very calm and explained things to me clearly. We finally underwent the surgery in April 2020 and now we are completely fine,” said the mother of Bhuvi Darshka, one of the youngest children who underwent liver transplant in Bangalore last year.
Living donor Liver transplant in children is one of the most challenging treatments that modern medicine is able to offer. The complex physiology of children, the technical challenges of the operation, care of the living liver donor all involve a synergistic multidisciplinary approach which results in the best outcome in these challenging problems.
“The liver is a crucial organ that manages multiple functions in the body, including waste management, metabolism, healing, blood clotting etc. When the liver function is affected by disease, it can lead to severe symptoms such as jaundice, abdominal pain, tremors, swelling in the legs, confusion, mood changes, etc which can affect the child’s growth and is very difficult for the child to cope with,” said Dr. Chetan Ginigeri, Lead Paediatric Intensivist, Aster Hospitals Bangalore.
The Integrated Liver Care team at Aster has conducted more than 98 pediatric liver transplants and more than 500 adult liver transplants since its inception. With its Affordable Liver Transplant initiative, countless families have been able to receive life saving organ transplant surgeries at a subsidized rate supported by crowd funding, corporate sponsorships from CSR budgets, cross-subsidies, matched funding and tie-ups with state governments.